Organization
AVALON DENTISTRY P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENISE M VANDEWALLE D.D.S (OWNER)
(719) 589-4771
Entity
Organization
Contact information
Practice address
815 WEST AVE, ALAMOSA, CO 81101-3028
(719) 589-4771
Mailing address
815 WEST AVE, ALAMOSA, CO 81101-3028
(719) 589-4771
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10535
CO
Other
Enumeration date
06/12/2007
Last updated
08/22/2020
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